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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AV-TEMECULA-CT MITRACLIP SYSTEM STEERABLE GUIDE CATHETER

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AV-TEMECULA-CT MITRACLIP SYSTEM STEERABLE GUIDE CATHETER Back to Search Results
Catalog Number SGC0301
Device Problems Mechanical Problem (1384); Device Operates Differently Than Expected (2913)
Patient Problem No Patient Involvement (2645)
Event Date 02/08/2018
Event Type  malfunction  
Manufacturer Narrative
(b)(4).During processing of this complaint, attempts were made to obtain complete event, patient and device information.The steerable guide catheter was received.Investigation is not yet complete.A follow up report will be submitted with all additional relevant information.
 
Event Description
This is filed to report the inability to straighten the steerable guide catheter (sgc).It was reported that during preparation of the steerable guide catheter (sgc), negative was applied, but a pop was heard and the sgc would no longer straighten.The device was not used in the anatomy and a new sgc was used to complete the procedure.There was no clinically significant delay in the procedure.No additional information was provided.
 
Manufacturer Narrative
(b)(4).The device was received and investigated.The reported mechanical issue of steerable guide catheter (sgc) unable to curve guide was confirmed.The reported noise could not be replicated in the testing environment as the event was a symptom of the cable break.A review of the lot history record revealed no manufacturing nonconformities.Additionally, a review of the complaint history identified no other incidents reported from this lot.The investigation determined that the reported noise and mechanical issue of sgc unable to curve guide were a result of the observed cable break; however, a definitive cause for the cable break could not be determined.Based on the information reviewed, there is no indication of a product quality issue with respect to manufacture, design or labeling.
 
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Brand Name
MITRACLIP SYSTEM STEERABLE GUIDE CATHETER
Type of Device
STEERABLE GUIDE CATHETER
Manufacturer (Section D)
AV-TEMECULA-CT
abbott vascular
26531 ynez road
temecula CA 92591 4628
Manufacturer (Section G)
MENLO PARK, CA REG# 3005070406
abbott vascular
26531 ynez rd.
temecula CA 92591 4628
Manufacturer Contact
connie speck
abbott vascular
26531 ynez rd.
temecula, CA 92591-4628
9519143996
MDR Report Key7310462
MDR Text Key101625153
Report Number2024168-2018-01520
Device Sequence Number1
Product Code DRA
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K161985
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Health Professional
Remedial Action Other
Type of Report Initial,Followup
Report Date 03/19/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/02/2018
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date11/28/2018
Device Catalogue NumberSGC0301
Device Lot Number71127U206
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer02/16/2018
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/12/2018
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/01/2017
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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